Rapid Opioid Alert & Response – (ROAR), a New Tool to Address the Opioid Epidemic in Local Communities

‘HHS Ignite Team continues their work after the program and scales up ROAR to save lives’

Mitra Ahadpour, MD, DABAM woke up on October 2, 2015 to a headline in The Chicago Tribune that shook her up.

74 overdoses in 72 hours: Laced heroin may be to blame

Ahadpour, a medical officer at the time, now the director of the Division of Pharmacologic Therapies at the Substance Abuse and Mental Health Services Administration (SAMHSA), thought about what she could do to help curb the opioid epidemic that has been sweeping the country.

Ahadpour, along with Gus Lodato, Chandler McClellan and Kaitlin White, also from SAMHSA, applied to the HHS Office of the Chief Technology Officer’s Ignite Accelerator program, which provides selected teams with methodological coaching and technical guidance within a fast-paced, entrepreneurial framework, but first Ahadpour’s team needed an idea to test and iterate within the HHS Ignite program.

It all started with a box of donuts and a chat with a former heroin dealer. Ahadpour knew about an outreach program for heroin and opioid injection drug users that the Baltimore City Health Department was running in December 2015 in West Baltimore. Ahadpour called the Baltimore City Health Department contact she knew and asked if she could come to the outreach program to hang out and listen.

On a cold December day, Ahadpour set out for Lexington Market in West Baltimore to test out her ideas for the HHS Ignite Accelerator Program with injection drug users.

She was a little apprehensive.

“They warned me. They said ‘They may not talk with you. You’re a newbie.’ I brought a box of donuts. I placed the box and stood on the side. They were talking with people, handing out the naloxone kits. One of them came to me and he was a former drug dealer. He said ‘I looked at you and said: Who is this person coming into our territory?’ But then he said, ‘I saw the donuts.’ He eventually gave me his seal of approval,” Ahadpour explained.

The meeting in Lexington Market spurred numerous follow-up conversations, during which she bounced ideas off of the injection drug users, health department staff and first responders from Baltimore. Would they want to know if there was really potent or laced heroin on the street? She asked.

“They said, ‘We care … we don’t want to die,’” she explained.

Ahadpour envisioned a system that would allow SAMHSA to communicate with local health organizations that work with drug users and alert them when there is a spike in overdoses in the area. This spike in overdoses can mean that there is especially potent heroin or that the drugs are being cut with high levels of Fentanyl, which is deadly in high doses. Ahadpour contacted users in the community to find out what they thought about her ideas.

Ahadpour and her team kept plugging away on their ideas and started looking for repositories of real-time data about overdoses in the community. Finally, Ahadpour applied to the HHS Ignite Accelerator boot camp in the spring of 2016 to sharpen the focus.

During the boot camp, she and her team from SAMHSA came up with a prototype. Using drug overdose data from 911 calls and a poison hotline, she worked with SAMHSA staff to set up a program on her laptop that would identify spikes in heroin overdoses in certain areas, which can help public health officials identify tainted heroin in a community.

During the HHS Ignite Accelerator program boot camp, Ahadpour’s team was coached and mentored in human-centered design and entrepreneurial methods. The HHS Ignite Accelerator program helped Ahadpour’s team to use the feedback from the injection drug users, health department staff and first responders in West Baltimore to develop a solution that would meet their needs.

As a result of the HHS Ignite Accelerator program, Ahadpour and her team developed ROAR, Rapid Opioid Alert & Response, an overdose electronic monitoring system that is based on 911 data. Local health departments, after they get an email alert about an overdose spike, can use this information to quickly respond to overdoses in the communities. ROAR also provides the health departments with information for the injection drug user community about addiction resources, including where to get Naloxone, a drug that can help save heroin overdose victims in most cases if administered quickly.

After the HHS Ignite Accelerator Program

The leadership of the Washington-Baltimore High Intensity Drug Trafficking Area (WB HIDTA) got wind of Ahadpour’s project and they liked what they heard.

“It’s really about the data. How can we share data to protect, support and save lives? Our mission is to help local law enforcement. It’s about how we can support them through intelligence. But we’re also the only one [HIDTA] that receives funding for drug treatment, so we find ourselves as a bridge between public health and law enforcement,” said Jeff Beeson, the deputy director at WB HIDTA.

Beeson said that the director of the HIDTA, was interested in the SAMHSA team’s work on ROAR and brought them in to discuss. The WB HIDTA was already in the process of geomapping opioid-related overdoses through their Overdose Detection Mapping Application Program (ODMAP).

The WB HIDTA team had the data and the SAMHSA team had an alert system, so they joined forces to scale up ROAR. As a result of the partnership between the WB HIDTA and the SAMHSA’s team, the ROAR platform is now available on mobile devices through an app. First responders can use the app to report whenever Naloxone is administered. This real time reporting by first responders into the app allows for the public health departments that work with injection drug users to quickly alert their communities that there is tainted heroin in the area. The teams piloted the system for about six weeks earlier this year in Baltimore City, Anne Arundel County, Maryland and two counties in West Virginia. They are now expanding into counties in South Carolina and in Florida, which just passed a bill (HB 249) that authorizes the data collection and specifically mentions ODMAP.

What Beeson and his colleagues have found is that by analyzing the overdose data, patterns emerge.

“We are drawing correlations. If this county has a spike, then we know that this other county is going to have a spike,” Beeson said, adding that Fire and EMS departments are using the data to plan ahead and becoming more proactive in responding to drug overdoses.

Opioid overdoses across the country remain at epidemic proportions, but Ahadpour is hopeful that ROAR, as it is scaled up and modified, can be a helpful tool for patients and providers. Beeson has traveled across the country to discuss ODMAP and ROAR and has more than 200 presentations under his belt, most recently in Ohio and Kentucky. Beeson has 60 teaming agreements signed with counties and municipalities to use ODMAP and ROAR and expects to have the app up and running in an additional 40 counties within six months.

Editor’s Note:  The ODMAP is available for free to States. For more information contact Jeff Beeson at jbeeson@wb.hidta.org. For more information on ROAR, please contact Mitra.Ahadpour@samhsa.hhs.gov.

HRSA Word Gap Challenge Yields Low-cost, Scalable, Tech-based Interventions

Crowded around a speakerphone at the offices of the Health Resources and Services Administration (HRSA), members of the Maternal and Child Health Bureau (MCHB) announced to Dr. Melissa Baralt that she and her colleagues had won the Bridging the Word Gap Challenge. When Dr. Baralt heard the news on the other end of the line, she was leaving a preschool where she had been assessing the language development of a child, and was delighted that the child’s vocabulary had improved since the last visit.  Hearing the news, she tearfully noted how hard the team had worked and that the $75,000 in prize money would allow the Hablame Bebe app to be freely available to the public.

After we delivered the news to Dr. Baralt, we were silent.  Many thoughts ran through our minds.  On one hand, we experienced a sense of relief.  Three years in the making, filled with planning, scrambling across the government to get required approvals, and uncertainty of whether we would succeed. On the other hand, we were excited to have tapped into a vast reservoir of innovation. Maybe federal challenges are something that should be more readily utilized across our agency to complement our large grant portfolio of programs. Was this the new way of doing business?

HRSA embarked upon this federal challenge to address the “Word Gap,” the large difference in exposure to language for children from low-income families compared to children from high-income families.  By age four, children from low-income families have heard 30 million fewer words than those from higher-income families. This affects how young children develop language skills, their performance in school, and eventually their success in life.

While HRSA and others are actively investing in research to better understand the Word Gap issue, we realized approaches to develop tools to encourage parents and caregivers to better interact with their kids and expose them to more words were also needed.  We crafted the Bridging the Word Gap Challenge to attract a wide range of innovators and to encourage development of low-cost, scalable technology-based interventions. These interventions would not only more immediately benefit children from low-income families, but serve as tools to further research.  It would also encourage more diverse approaches to increase the odds of breakthrough solutions.

Dr. Baralt’s team’s solution, Hablame Bebe, was exactly the outcome we had envisioned. Hablame Bebe is a dual language app that promotes “language nutrition” and builds on cultural strengths and beliefs to reduce the word gap for low-income children. The other teams’ interventions represent an incredible diversity of approaches and expertise, including wearable devices that measure words spoken to a child, apps that provide feedback  and modeling to caregivers, apps that are location-based and send prompts to parents in real-time, and community-based strategies.

We designed the challenge as a three phase accelerator, allowing us to widen the aperture initially and to select and support only those approaches that demonstrated value. In Phase 1, we issued a call for ideas, detailed in five pages or less.  Of the 80 submissions, we selected 10 to proceed, providing each with $10,000. The low barrier to entry allowed non-traditional participants with promising ideas but perhaps too few resources an opportunity to apply.  We leveraged both traditional and social media as well as partnerships to reach a broad audience, and received submissions from individuals, private businesses, and non-profit organizations. The unexpectedly large and diverse response validated to us how well a challenge could easily engage a broad set of innovators focused on solving a particular problem.

Passage into Phase 2 unlocked a suite of resources for the 10 teams. HRSA provided access to one-on-one mentoring with a select group of challenge advisors, HRSA staff, and the challenge contractor Sensis, Inc. The teams were given six months to fully develop their intervention (or, if already developed, to implement the changes that were described in the initial application) and test its usability on a small target population.  We invited the nine winners (one team chose not to continue participation) to the Department of Health and Human Services (HHS) headquarters in Washington, DC to pitch their intervention in a live “Shark Tank” style presentation (Demo Day) to the challenge advisors, judges, and the public. The nine teams had a chance to interact with panelists, private sector incubators, other federal staff, and of course, each other. They received insight on options to continue development and ensure broad reach of the interventions.  After the day of presentations, we announced five winners, each receiving a $25,000 cash prize.

Phase 3 required the final five teams to demonstrate low-cost scale of their intervention, supported by evidence.  We held a virtual Demo Day six months later, and selected the final winner.  

The challenge yielded many desirable results.  Of course we awarded a grand winner that demonstrated the most promising product, but we also catalyzed the development of four other evidence-driven products that are currently available to the public, and in so doing proliferated multiple interventions to address the Word Gap. We linked the winners from each phase to our Bridging the Word Gap Research Network (http://www.bwgresnet.res.ku.edu/), where they have access to partnership with researchers in this field. We helped convene “Silicon Valley” approaches to a complex problem not often approached that way within the Federal Government. The Maternal and Child Health Bureau will continue to support the cohort of semi-finalists, and to provide them with additional opportunities for connection, collaboration with federal programs and partners, and opportunities for further promotion and partnerships.  Several teams offered unsolicited feedback immediately after the challenge had concluded.

One semi finalist shared,  “I wish more of the Federal Government were like this. In contrast to this experience, I’ve submitted super long grant applications with bizarre formatting requirements. The result is normally an unnecessarily complex explanation for what we’re working on. Due to their sheer length, I now disregard most such programs. In contrast, I have nothing but positive things to say about this experience. If the government really wants to attract innovation from places like Silicon Valley this is how you should do it.”

The winning team told us, “The ‘Incubation Structure’ of this challenge is precisely why and how we learned what we did. Had it not been for the deliberately different phases, had it not been for the explicit ‘What did you learn? What mistakes were made? What did NOT work?’, I do not know if I would have changed my approach of inquiry.”

We are confident that as a result of this challenge, we have made a real impact in addressing the Word Gap on a national scale to ensure that all kids have a fair shot at reaching their fullest potential.

Challenges with our Challenge

While we recognized the unique value of using challenges to address complex problems at HRSA, the execution was a learning experience. Most of the HRSA staff were unfamiliar with the reauthorized COMPETES Act prize authority, so it was often difficult to navigate approval from various approving offices. We learned that as an organization we need more familiarity with the COMPETES Act, so we are able to effectively leverage the challenge mechanism when a need arises.

A key factor in our success was the support of champions at HRSA and HHS. Associate Administrator for Maternal and Child Health Dr. Michael Lu, and our HRSA Acting Administrator Jim Macrae were incredibly committed to working out the internal challenges that arose in order to keep the project moving forward. Our advocate in the HHS IDEA Lab, Sandeep Patel, was incredibly helpful in continuously providing guidance on issues that came up, in providing examples of other agencies’ challenges to use as models, and in tirelessly supporting our program staff in their efforts to maneuver the red tape hurdles that were often disheartening.

The Maternal and Child Health Bureau at HRSA clearly sees the power of the federal challenge mechanism to attract a broad swath of innovators from the public we otherwise could not attract, focus public attention on an issue, and catalyze development of innovative products to address that issue so rapidly.

Read about the winners here: https://www.wordgapchallenge.hrsa.gov/content/champion

HHS Ventures Team Helps Detect Disease Outbreaks

The figure above is not an exotic, tropical flower in bloom, but a transmission cluster of Hepatitis C patients sampled during a single outbreak using GHOST – Global Hepatitis Outbreak Surveillance Tool

Using tech to fight disease is a no brainer

It was a no brainer for the HHS Ventures Fund to include the Centers for Disease Control and Prevention’s (CDC) GHOST project in its latest round of funding.

There are about 3.5 million Americans infected with Hepatitis C (HCV), which attacks the liver and can lead to cirrhosis and other serious health problems, according to the latest data collected by the CDC. This CDC Ventures team is developing a cloud-based, public health research tool to help state and local health departments more quickly detect and fight the spread of disease. The team calls their system GHOST – Global Hepatitis Outbreak Surveillance Technology. Sumathi Ramachandran Ph.D., a CDC scientist who had used an earlier version of the GHOST tool, presented research last year about the CDC’s response to a large, 2015 HCV outbreak among injection drug users, explaining that it contained nearly 400 HCV specimens, of which about 25% were co-infected with HIV. Ramachandran praised the system for its ability to aggregate and present genomic sequencing data and quickly allow interventions.

“GHOST is a game changer,” said Ramachandran, “It integrates new laboratory methods and analytical web-based tools and offers a report which is very end-user friendly.” She explained that GHOST helps scientists visualize the spread of Hepatitis C and begin to identify “super spreaders.”

The CDC’s team pointed to a  “super spreader” they helped to track down. Many in New Hampshire, and around the country, remember the story of a hospital worker who infected dozens with HCV. By reusing a syringe when he stole Fentanyl and replaced it with saline tainted with his blood, a former contract hospital worker who worked all over the United States, infected more than 30 patients with HCV. The culprit’s own genetic biomarker eventually became his downfall. GHOST will help to quickly identify HCV infection as more state and local health departments begin to use the tool.

“It’s an automated, big data, anomaly detector,” said Yuri Khudyakov, Ph.D. Khudyakov;  the project lead, Gilberto Vaughan, Ph.D.; David Campos, Ph.D.; developer Seth Sims; and others at CDC, created the system with the end user in mind, the researchers said.

The GHOST platform identifies transmission clusters of HCV patients and allows states and local labs to access the web-based portal and immediately start to investigate a cluster or outbreak. “State and local labs do not have the resources to do these types of genetic analyses or extract the data in such an easy to understand way” Khudyakov said.

The team from the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention designed and developed GHOST and is now piloting it in five states (Alaska, Michigan, New Hampshire, New York and Tennessee) and has heard from public health officials in Latvia and Georgia interested in the system. The GHOST team will use their Ventures funding to continue to iterate and improve the tool based on the pilot results.

Vaughan said their team is holding training in August for state and local health departments to “show them our protocols” and explain GHOST’s capabilities. Vaughan said they are excited to share the tool with public health officials across the country so they can use its analytic capabilities to identify outbreaks sooner and respond faster.

Ventures History: The HHS Ventures Fund was created in 2013 to stimulate innovative solutions across the Department. The initiative focuses on new ideas and actions that alter and improve the way the Department does business. HHS employees with proven ideas for how to dramatically improve their office, agency, or the Department’s ability to carry out its mission are encouraged to apply. Every year since 2013, after a competitive vetting process, teams are selected to receive growth-stage funding and support to develop and implement their efforts.

HHS Ventures is now in its fourth round. In earlier rounds, HHS Ventures has supported efforts, such as operationalizing an online portal for sharing 3D-printable models related to biomedical science, leveraging algorithms to review medical records and reduce labor of estimating the prevalence of autism in the U.S., and piloting a single sign-on Health Information Exchange system in California for providers.

Editor’s Note: Interested in learning more about GHOST? Contact Vaughan and his team here and read more about the technology in the March 15 edition of The Journal of Infectious Diseases, which put GHOST on its cover.

Health Datapalooza 2017 – The Data Revolution Rolls On

In 2009, a small group gathered for the first Health Datapalooza with the hope of spurring data transparency throughout the health care system and thus innovation. The concept was initially conceived as the Community Health Data Initiative and is described above

Themes for the 8th annual Health Datapalooza include consumer market places, value based care and health care redesign through data

The 8th annual Health Datapalooza returns on April 26 – 28 and offers a re-imagined vision of health and health care through the lens of data. In years past, Health Datapalooza has set its sights on health-care startups, apps, big data, electronic health records – you name it – but the main thrust was always more about the business of health care and how tech and data are used to innovate.

The annual conference for data geeks, developers, health tech venture capitalists, and start-up wannabes, among others, will this year triangulate around the idea that the patient should be at the center of health care.  Consumers are increasingly interested in the choices and options available to them, and want more control over decisions about their choice of providers, health care interventions and decisions about healthy foods and activities. Patients want these choices to be more integrated into their lifestyles.

This year, Health Datapalooza, powered by Academy Health, HHS, and others, is targeting a number of patient-centered themes to help patients become informed consumers. There will be opportunities at Health Datapalooza to learn how big data, analytics, cyber tools and tech can improve care and help improve outcomes. Speakers at the conference will be talking about the consumer/provider interaction experience and how it is being transformed by technology – think telemedicine or how value-based care programs have helped reduce hospital readmissions. The agenda includes sessions devoted to “Patients as Co-Pilots,” the “Empowered Patient,” and the “Consumer Marketplace.” Patient-generated health data, patient matching, patient portals, and patients as “co-pilots;” are front and center at this year’s conference. There are also a number of sessions devoted to privacy and security in health data, a perennial focus.

But merely making data available isn’t enough. One of the purposes of Health Datapalooza has always been to identify areas for innovation. The conference serves as an open platform for engaging people who have bold ideas on the use of health data and enlisting them to help revamp how patient data is contributed – by and for patients – and used to innovate.

Don’t Miss Out On…

Two New Challenges Will Be Announced

  • HHS will launch a new data challenge, The Healthy Behavior Data Challenge as a collaboration with the Public Health Authority-Canada, and the CDC and the HHS IDEA Lab’s own Sandeep Patel will be on hand at the HHS IDEA Lab booth to answer your questions about what that is all about.
  • Patient matching – a thorny challenge that centers on ensuring that the electronic data on hand matches up exactly to the patient in the examination room – is the target of the second challenge, the HHS-HIMSS Patient Matching Challenge.

International Delegations

  • Health ministers and delegates from eight countries around the world are working together to establish common principles for the use of health data, and enable the establishment of a global business platform for applying health systems data to spark innovation technology and business solutions. At HHS, we are working internationally to foster economic development and help facilitate innovation, surmount boundaries, cross borders and enable electronic health data to be available when and where it’s needed.

Code-a-thon on April 26th

  • HHS is contributing to an off-site code-a-thon with partners at 1776, so there will be ample opportunity for developers and data entrepreneurs to test and modify new ideas to help patients.

Check out the IDEA Lab at the Exhibition Hall

  • The IDEA Lab staff and a number of HHS innovators and Entrepreneurs in Residence will be on site at the IDEA Lab’s booth in the Exhibitor Hall at the conference. Follow the IDEA Lab on Twitter (@HHSIDEALab) for updates on speakers and events at the IDEA Lab booth.

My Experience at HDP

We created Health Datapalooza in 2009 from the simple idea that transparency and exchange of data throughout the health care system would unleash massive innovation.  Together, we have shaped this event into a platform for catalyzing change by dialogue, testing of new ideas and technologies, providing context to the value of health care and incentivizing business development at the leading edge of the new health economy. Using data as the fuel for innovation, Health Datapalooza stands today as a dynamic symbol for a vibrant, value-based ecosystem that was imagined nearly a decade ago. In the diagram above, we tried to describe this effort.  As a founder of this data-enabled movement for health-care system innovation, I can see the remarkable culture change that has come about through the liberation of data.  Now, let us continue the revolution of data-powered innovation to shape the new frontier of health and health care in America. ¡Viva la Revolución!

Editor’s Note: There’s still time to join us at the Washington Hilton for Health Datapalooza 2017. Sign up now!

Making Personal Health Data Available During an Emergency: HHS Ventures Fund Alumni Making Data Available When and Where it’s Needed

Major fault lines in Northern California

Major fault lines in Northern California

If you or your family were injured during a disaster like a hurricane, earthquake or forest fire, wouldn’t you want your health data to be available to first responders and others who are there to  provide care?

We thought you might, and we are partnering with the State of California to pilot just such a project.

Working at the Office of the National Coordinator for Health Information Technology (ONC), we have had the opportunity to leverage investments in health information technology to spur innovation in  public health and preparedness. We are especially excited about a project that had its beginning here at ONC but only really came to fruition thanks to a unique federal-state collaboration between the HHS Assistant Secretary for Preparedness and Response, the HHS Office of the Chief Technology Officer, and the State of California.  

The project, Patient Unified Lookup System for Emergencies (PULSE), received seed funding of $50,000 from the HHS Ventures Fund in July 2014. PULSE was designed to connect patients with their personal health records in some of the most challenging conditions imaginable – a natural disaster.

Here’s the update: the original HHS Ventures project (EMS to HIE Innovation), now known as PULSE, received an additional $2.75 million Advance Interoperable Health Information Technology Services to Support Health Information Exchange grant from ONC in July 2015.

In late 2015, the California Legislature passed and Gov. Jerry Brown (D) signed into law  four bills that support and extend the electronic exchange capabilities of the system to spread throughout the state’s 58 counties and 53 Congressional Districts.

Dr. Howard Backer, director of California’s Emergency Medical Services Authority (Cal EMSA), wrote last January that the “recent legislation, in addition to multiple data initiatives, is driving rapid changes in EMS data systems at the local, state and national levels.”

PULSE is currently being built to facilitate exchange during a declared emergency by extending interoperability across disparate technologies to support health information exchange. PULSE will allow Alternative Care Facilities (think of these as aid stations or MASH units set up during an emergency) so that EMS and authenticated volunteer providers can quickly get access to often life-saving data, when and where they need it. In the future, the PULSE system could facilitate patient lookup capability in an  ambulance.

During a recent demonstration by Audacious Inquiry, the contractor that developed the PULSE technology, the program’s benefits become readily apparent. In the event of an earthquake, or forest fire (like the one that recently ravaged Eastern Tennessee), first responders (defined under PULSE as any of six provider types, including doctors, nurses and EMTs) can query PULSE with standard eHealth exchange patient demographics—including name, date of birth, and gender.  PULSE then sends out data tendrils to California-based HIEs, health systems and hospitals, for instance, looking for a match to the query. PULSE then enables first responders to see recent care notes from treating providers – including hospital discharge summaries and the Consolidated Clinical Documents (CCDs).

As PULSE is being developed, we have tried to ensure that it can be a model for other states to use. To support future scalability, PULSE is utilizing industry standards when communicating with HIEs and hospitals.

To provide a glimpse into the impact of PULSE—it has the potential to ensure resiliency and redundancies in the world’s sixth largest economy, California.  PULSE will not only protect vulnerable patients but ensure that first responders and other providers have access to patients’ clinical documents at the point of care – a real limitation evidenced during Hurricane Katrina. This allows first responders and providers to make more informed clinical decisions for patients.

Cal EMSA is planning a “table top drill” to test PULSE’s capabilities in June 2017 – along with four connected HIEs that will process PULSE patient queries and return clinical documents – and will also hold its fourth annual California Health Information Exchange in EMS Summit which will include workshops and a “Fireside Chat” April 3-5, 2017 in Anaheim.  This conference is open to all to attend and will showcase cutting edge EMS and HIE projects from around the country.

Editor’s Note: Got a similar innovation story you want to tell? Let us know. Thanks for reading.

Innovation as a Problem Solving Tool in Government

A team supported by the HHS Ventures Fund developed a data-driven approach to public health emergency investments.

A team supported by the HHS Ventures Fund developed a data-driven approach to public health emergency investments.

The U.S. Department of Health and Human Services (HHS) faces an increasingly complex mission amidst rapid technological change.

It has been my honor to serve as the Chief Technology Officer (CTO), working with and supporting colleagues across HHS to improve operations and more efficiently deliver services to the American people. As I close out my time here, I’d like to highlight the accomplishments of our front-line public servants.

The Office of the CTO is charged with promoting innovation and open data across the Department. Our approach to the challenge of creating a culture of innovation is to help HHS employees and leaders shine a spotlight on a problem, and then invite people from the private sector to contribute their expertise. HHS employees also use our programs to test and develop their ideas in an entrepreneurial environment.

Our programs include:

Ignite Accelerator: Empowering front-line HHS staff to test new ideas

• 71 teams have participated, with 13 new teams starting their training on January 30.

Ventures Fund: Investing in and scaling internal innovations that dramatically improve HHS’s capabilities

• 11 projects supported, with a record number of applicants now being considered for the 2017 round.

Innovates Awards: Celebrating trailblazers from across the Department

• 50% of awardees had partnered with organizations outside of government.

Entrepreneurs-in-Residence: Recruiting outside talent to solve complex challenges

• 21 entrepreneurs have joined HHS to complete a tour of duty and we are currently recruiting for a systems architect.

Competes: Tapping into the ingenuity of the American people to solve problems

• 140+ prize competitions have attracted 9,000+ participants from across the U.S to source solutions.

Health Data: Unleashing the power of open data to improve health and human services

• 3,000 data sets are now publicly available, up from 30 in 2010.

Invent Health: Identifying emerging opportunities and challenges in health and technology

• Stimulated a national conversation on hardware innovation in health.

Buyers Club: Modernizing IT acquisition by testing new methods

• 100% of directly-supported projects awarded contracts to small businesses.


Read case studies and examples for each of these initiatives (PDF).

cover page for report "Innovation as a Problem Solving Tool in Government"

We have made significant progress in helping teams and individuals think of new ways to tackle important challenges. But there’s much more that can be done. As you read about each program, I invite you to consider how innovation and entrepreneurship might continue to help HHS better deliver on our mission to enhance and protect the health and well-being of all Americans.

Say What You Want To Say. The World Is Waiting.

two children laughing, playing, communicating

Sometimes a slap in the face (or a less painful equivalent to the ego) is a great wake-up call.  That’s how I internalized the importance and power of good communication.

I’ve always loved words and writing, but I would often over think my writing in certain contexts.  In a former life, when I was completing a degree in International Development, one of our initial assignments was to define “development.” Easy enough?  Well, in an effort to prove myself, I tried to sound as brilliant as possible with a super esoteric response that got me a, “See Me,” from the Professor in our Department who was most focused on the quantitative impact of international development interventions. Basically, a person that I thought cared more about the numbers.  In our meeting, he asked me to explain in words what I typed out.  After explaining in simpler, more authentic terms, he said, “Well, why didn’t you write that?” As I was leaving, he told me, “You owe it to the people you want to serve, to communicate in a way that they will understand.”  That has never left me.  It’s become essential to the way I view communications work.  It’s our responsibility but also a great privilege and opportunity to communicate effectively to the public around health and health care.

While there might be colleagues that reinforce the public stereotype of the apathetic government employee, we at the HHS IDEA Lab/Office of the Chief Technology Officer work with the opposite profile.  We work with mission-driven teams from across HHS who want to solve problems that would improve the way we serve the public.  They may need help in fleshing out the core problem and their ideas.  They might need more leadership support, a space to experiment, and access to tools and methods that would help.  But they are ALL committed to working smarter and more efficiently.

In my role as Director of Communications for two years and a newbie to federal government, I had the privilege of listening to and sharing out the work, insights and lessons learned from incredibly smart colleagues from across the Department.  At first, I questioned my role. With all of these experts in their respective fields, what value could I add?  Then one day, I found myself listening to a complex explanation of an immensely important project. That was just the beginning. I started to hear from more teams, more critical projects, more narratives that you had to ask questions and sit with more to really “get” as an outsider. And then, it clicked.  I’m here to help translate. I’m a bridge.

It has been my observation that communications work and activities are often considered a tool and an afterthought. This is felt more strongly in some sectors than others.  Yet with information coming at you today in so many different forms, with varying accuracy and at breakneck speed, I would argue that creative and compelling communication efforts that resonate with your audiences are even more critical.  Is it important to share your work, idea or innovation with consumers, with the world?  Do you want more engagement from the public? Well, communication is key to your success.

And if you agree, here are three key takeaways to remember:

Keep communication in mind from the beginning.  

If you are working on a project where outreach and communications may be necessary at some point, integrate that into your thinking and approach from the beginning itself. Involve your communications teams and available resources (if you have them) so they can plan and get creative early.  Identifying and understanding your goals, target audiences, key messages and desired actions in advance, might even influence the way you develop and implement your project.  

Make it easy. Keep it simple. It’s your responsibility.

We owe it to those we serve and support, to communicate in a respectful way that more people can understand.  It helps to take a step back and ask yourself – how would I explain this to a family member or friend that has no clue what I’m working on?  You might also consider stories that better illustrate the details and impact of what you are trying to convey.  Visuals can be compelling as well as metaphors that have the power to create a visual image with words.  E.g. This new platform will be the Facebook for X.   In other words, do your best to make your words and work accessible. It’s empowering for everyone.

Listen, be open and respond accordingly.

After you put out a blog or a tweet or a press release, use analytics and other feedback mechanisms to “listen,” and get a sense of what is working and adapt and adjust your approach accordingly.  As someone who enjoys communicating in different forms, it’s easy to get caught up in trying to perfect or want to follow a particular prescription of what activities you should undertake.  Resist the urge!  Every other day, a different digital platform or tool to share, crops up.  Stay flexible, experiment and let what you are hearing (using both qualitative and quantitative measures) guide you on the steps you take next.

Ultimately, your brilliant innovation, opportunity, idea, or message is just that – in lonely, isolation – without effective communication.  I know that there are many powerful examples of improvement and innovation that are happening within the walls of this Department to better enhance and protect the health & well-being of Americans. I had the honor of helping to communicate some of them.  

Let’s share them more and let’s share them well.

Modernizing our Public Health Surveillance Systems

Disease surveillance is the foundation of public health practice providing essential data to inform decision making and respond to health threats. In the past, surveillance systems were fairly simple and might require disease-specific data collection forms (paper or electronic) that were completed by epidemiologists and sent by fax or email, databases to store data that were often entered by hand, and tools to analyze and chart or map the data. Surveillance today is more complex. Data collection systems need to capture standardized data from electronic medical records or other sources, package that data into structured messages, transport the messages between systems, validate the messages for accuracy and completeness, unpack the messages and transform the data, provision the data into databases, and pull the data from the databases for analysis and visualization. And, it all needs to be done accurately and in near real-time, or as fast as possible. As an example, the figure below depicts the data flow for nationally notifiable diseases that are reported to CDC by state health agencies.

National Notifiable Diseases Surveillance System Data Flow

CDC’s surveillance systems serve critical public health functions but many of our systems use aging technologies that have been patched together over time and need to be rebuilt or replaced. We need systems that are less complex than the monolithic systems we use now, can easily be updated, and can be extended for multiple data collections purposes (see blog “Developing Forward Looking Software at CDC”). With this in mind, we are exploring technologies such as application programming interfaces (APIs) and microservices that are used successfully by many other organizations to deliver timely, high-quality data when and where it is needed.

The biggest challenge we face in modernizing our surveillance systems is not the technology; it is the changes that we need to make in our infrastructure and culture. We need to employ new methodologies such as agile development and DevOps for building, testing, and deploying our systems. We need to modernize our approach to IT governance to ensure systems and data are secure, and can handle automated iterative testing, discrete functionality monitoring, frequent deployment of software updates, and on-demand scaling. Equally as important, we need to enhance the IT workforce and change the way we procure and manage IT contracts. Current rules and funding cycles make it difficult to procure cutting-edge experience and expertise, coordinate across multiple IT projects, and transition systems from one contractor to another. Regardless of whether we build, borrow, or buy software, we need a workforce with knowledge of advanced industry standards and best practices to provide oversight of contract work and to make informed decisions about the technologies we need to build robust surveillance systems.

HHS IDEA Lab programs such as the Entrepreneurs-in-Residence (EIRs) are helping us to address these challenges. Our two EIRs—a software architect and a data architect—are creating an R&D team to pilot and test new software, developing a metadata repository to coordinate and standardize the data we collect, drafting architectural blueprints to guide future software development, and establishing new processes like DevOps to improve collaboration across the agency. The innovation and disruption brought by the EIRs has been just the spark we needed.

The modernization of our surveillance systems won’t happen overnight but we are moving in the right direction with the ultimate goal of providing the right data to the right person at the right time for effective public health action.

This blog was cross-posted from the CDC’s Division of Health Informatics and Surveillance (DHIS) Blog.

With Our Forces Combined

post it mosaic brainstorm at an IDEA Lab event

Results of white boarding session around why attendees came out during HHS Innovation Day (7/14/2016)


A new vision and approach to greater health calls for a world where everyone is a changemaker. Where everyone is empowered with that belief. Even government employees working in a corner of a large, hierarchical bureaucracy.

As a space that promotes innovation within the U.S. Department of Health and Human Services (HHS), we are at the crossroads of many “What if,” questions. What if we could promote the use of innovation across the Department to better deliver on our mission to enhance and protect the health and well-being of the public? What if we applied lean and design-centered thinking approaches to the critical challenges we encounter? What if red tape and the fear of failure didn’t stand in the way of a winning idea to improve efficiency? Our work begins with defining the problem, collaboratively imagining what’s possible, and helping teams as they navigate towards that vision.

Under the leadership of our Chief Technology Officer, Susannah Fox, our small but mighty team has had the privilege of supporting and listening to entrepreneurial ninjas both within and outside government. These teams and individuals are committed to harnessing the power of technology, data and innovation as a force for good in health.

We have supported some pretty awesome projects and efforts ranging from leading the charge to liberate health data from HHS agency vaults to transforming the organ procurement and transplantation system to making 3D printed biomedical models more accessible for medical research, discovery and care. As a government agency, we may never be at the cutting-edge of health innovation. We may as well face it. Yet, at the same time, WE ARE part of a complete vision of shaping a healthier world. And that’s why nurturing and growing creative thinking and action within government agencies like HHS is so important.

The IDEA Lab has worked with some incredibly fearless, mission-driven innovators within our Agency who are determined to hack red tape and better serve the public with little or no glory. We have also met amazing communities of entrepreneurs, scientists, makers, patients, clinicians, engineers and everything in between who are leading the way to better health, and creating the path as they go.

What if those superpowers came together and worked in greater synergy?

We look forward to imagining that “what if,” for health and medicine.


This is a modified version of a cross-post from the TEDMED 2016 blog

Interested in engaging in our efforts to hack red tape to better serve the public?  Great, we have two ideas in mind:

*For fellow HHS innovators and problem solvers, the HHS Ventures Fund is currently seeking to invest in proven, early stage solutions to better deliver on the Department’s mission. Learn more and apply today (thru December 20th).

*Sign-up for non-spammy updates from us on opportunities, events and generally what we are up to.

Thank you for your commitment!

Making It Stick: Applying HHS IDEA Lab Principles for Lasting Change

Think Outside the Box!

Like others who have participated in HHS IDEA Lab programs like the HHS Ignite Accelerator, I felt refreshed and inspired after learning the entrepreneurial, lean startup based concepts that are taught to teams. I practiced them regularly during my time in Ignite, but after the program ended, I felt the natural tendency to revert to the status quo back at my office. And I really didn’t want to let that happen. So, I didn’t.

To give a bit of context, I have been working as a software development project manager at the National Institutes of Health (NIH) for seven years. In 2013, I had the good fortune of being part of a project team that was selected for the Ignite Accelerator. Our project involved prototyping and then building an online repository for biomedically-relevant, 3D-printable files, called the NIH 3D Print Exchange. My responsibilities included fulfilling many of the project management duties for the team, but given the short timeline and the freedom to experiment within the Ignite framework, I was able to work in a less formal way than I normally had for my previous projects.

At some point early on in the Ignite program, I had a revelation. I think it had something to do with realizing that I was doing something for years that could be done differently (and done better). Or maybe it was that the methods being taught were becoming commonplace in the business world, and I learned that it was possible to adopt and apply similar ways of working within a government setting. Whatever it was, I decided to completely change how I go about my day-to-day work. And since 2013, I’ve diligently been trying to bring these changes into my organization. My primary motivation was that my old way of working was simply less effective than what I was doing within Ignite – and it was something that I never wanted to go back to.

Ignite’s “lean” approach may seem intuitive, but it was very different than the way I had been trained and even had become certified to work as a Project Management Professional. In the past, I would often painstakingly conduct upfront planning, formally gather requirements, and rigidly set schedules and budgets before starting a project that might last many months or even span years. I would follow standard processes and document everything meticulously. Yet, months into the projects, I would find that I had eschewed my plan, that my requirements had changed, and that I wasn’t meeting the original schedule and budget milestones. I often felt discouraged, and assumed I needed more training and practice. So I focused on trying to do the same things, but better.

My experience in Ignite made me realize that I had been working to refine what was, at least for me, the wrong approach. The formal processes simply didn’t fit with me or my organization, and I have come to accept that both I and my projects are better off if I adopt a new way of thinking and working.

So I shifted my focus to Ignite-based principles, and especially on spending time early on in projects doing the following:

  • developing clear problem statements and value propositions for stakeholders
  • creating, testing, and refining hypotheses continually
  • building prototypes or minimum viable products, using design thinking and related techniques, with the goal of getting the most critical components of the system “right”

All of this this led me to have more regular and meaningful communication with prospective users of the systems my teams were creating, to regularly solicit feedback from stakeholders on prototypes, and to reduce project risk by developing software in more bite-sized chunks rather than trying to build the entire system at once.

Around the same time as my Ignite project, I also came across a movement called agile software development that was gaining traction among professional software development groups, and that was related to lean startup. (Those practicing this methodology even have a manifesto!) Everything in my professional life started to converge, and my eyes were opened to what was, to me, a much more practical and effective way to do my job.

Looking back, I can say that these principles not only feel right, but they actually work! The NIH 3D Print Exchange project was developed more quickly and became more successful than any other project I’ve worked on. (In fact, it won numerous awards, was covered in dozens of media outlets, and even resulted in an invitation to an event at the White House to showcase our work!) Over the past few years, I have coordinated other development teams that have created other products using these Ignite-inspired approaches, and each has unequivocally displayed enhanced outcomes.

Based on this success within Ignite, I lobbied for broader adoption of these approaches across my 40-person office at the NIH, which has led to group training sessions, adoption of tools and techniques to support our new way of working, and the certification of multiple employees in the various roles associated with agile software development. I’m extremely optimistic about what our organization can achieve as we establish better ways of working by understanding our users and by applying agile, startup-based methods to our work.

I certainly cannot take full credit for this transformation, and I readily admit that I am very fortunate to work in an open, risk-tolerant work environment, with colleagues and managers who were receptive to, and who have become champions of, these new ways of working.

I urge those of you who have participated in Ignite – and even those who haven’t – to consider questioning the status quo and being open to these refreshing ways of working. While adopting lean/agile and design-thinking-based approaches may be uncomfortable at first, you just might find that something “clicks” for you as it did for me. If it does, I encourage you take the initiative to find ways to make these changes stick in your organization. While they won’t come overnight, I think you’ll learn a lot and ultimately find great benefits in making a similar transformation in your work!

If you want to explore this further, including additional strategies and examples of other transformations toward more lean and agile ways of working, both inside and outside the federal government, please sign up for the HackRedTape email list. Also, don’t forget to learn more and consider applying to the Spring 2017 round of the HHS Ignite Accelerator! (Applications are due November 14th!)